Rebound migraines after surgery?

Full Question:

I have migraines very often & they are extremely intense. Recently I had surgery & since surgery I have been suffering from a rebound migraine for 8 days. I can't function at all. I've tried Toradol, Percocet & a muscle relaxer. Nothing works! Any suggestions? Heidi.

Full Answer:

Dear Heidi;

One of the most difficult issues facing those of us with migraines is that pain medications taken for other reasons, such as your surgery, can result in medication overuse headache (MOH), aka rebound.

Usually, it's recommended that the use of all acute migraine abortive and pain medications - triptans such as Relpax, prescription pain relievers, and over-the-counter pain relievers - be limited to no more than two or three days per week in order to prevent medication overuse headache. You can find more information on MOH in Medication Overuse Headache: When the Remedy Backfires. That said, in somewhat of a no-win situation since you need pain relief following your surgery.

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This is sometimes an unavoidable problem when pain relievers are needed for other issues. In your situation, you may well have to treat the post-operative pain as long as necessary, and worry about the MOH when you no longer need post-operative pain relief. Something that can make this easier is using single-ingredient pain relievers for your post-operative pain as opposed to multi-ingredient pain relievers that have more than one substance that can cause MOH. MOH is usually headache, NOT migraine, and it's usually relieved by whatever medication caused it.

The best suggestion we can offer is to request the doctor treating you for migraine and the doctor prescribing your post-operative treatment to schedule a conference call with them and with you to discuss a plan for your treatment. Don't forget that, as the patient, you're a part of your health care team, and asking your doctors to consult is never out of line. One thing you might ask your doctors about is a course of steroids to break the cycle of headaches.

Thanks for your question,David Watson, MD, and Teri Robert

About Ask the Clinician:

Dr. David Watson is a UCNS certified migraine and headache specialists and director of the Headache Center at West Virginia University. He and Lead Health Guide Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Watson or more about Teri Robert.

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